Pommier P, Bolot G, Martel I, Montbarbon X, Ardiet J M, Coquart R, Poupart M, Leval J, Ramade A, Dubreuilh C, Pignat J C, Carrie C
Department of Radiotherapy, Centre Léon Bérard, Lyon, France.
Int J Radiat Oncol Biol Phys. 1997 Apr 1;38(1):53-8. doi: 10.1016/s0360-3016(97)00219-8.
Brachytherapy performed in patients with posterior pharyngeal wall carcinoma in a previously irradiated area is evaluated in terms of local control, survival, and complications.
Between January 1982 and July 1993, 14 patients were treated with interstitial low dose rate brachytherapy alone for posterior pharyngeal wall squamous cell carcinoma in a previously irradiated area (local recurrences in five cases and second tumors in nine cases). Tumor size ranged from 1 to 4 cm. No patient had a macroscopic nodal involvement or metastase at the time of diagnosis. Median dose delivered was 55 Gy (39 to 60 Gy).
Thirteen patients were assessed for local control. Twelve of them achieved complete macroscopic response within 2 months after brachytherapy. Local relapse occurred in five patients, from 5 to 29 months after brachytherapy. One patient developed distant metastatis without loco-regional relapse. Disease free survival was 69, 59, and 37% at 1, 2, and 5 years, respectively; overall survival was 78, 50, and 21% at 1, 2, and 5 years, respectively. Three patients were still alive without recurrence (8, 8, and 10 years after treatment). We did not observe any severe acute or delayed toxicity.
Based on these results, interstitial brachytherapy should be considered as a potentially curative treatment for selected patients with posterior pharyngeal wall squamous cell carcinoma in a previously irradiated area. There are no reports in the literature on this subject.
对先前接受过放疗的下咽后壁癌患者进行近距离放射治疗，评估其局部控制、生存率及并发症情况。
1982年1月至1993年7月期间，14例先前接受过放疗区域的下咽后壁鳞状细胞癌患者（5例为局部复发，9例为第二原发肿瘤）仅接受了组织间低剂量率近距离放射治疗。肿瘤大小为1至4厘米。诊断时无患者出现肉眼可见的淋巴结受累或转移。中位给予剂量为55 Gy（39至60 Gy）。
对13例患者进行了局部控制评估。其中12例在近距离放射治疗后2个月内达到完全肉眼缓解。5例患者在近距离放射治疗后5至29个月出现局部复发。1例患者出现远处转移，无局部区域复发。1年、2年和5年的无病生存率分别为69%、59%和37%；1年、2年和5年的总生存率分别为78%、50%和21%。3例患者仍存活且无复发（治疗后8年、8年和10年）。未观察到任何严重的急性或迟发性毒性反应。
基于这些结果，组织间近距离放射治疗应被视为先前接受过放疗区域的特定下咽后壁鳞状细胞癌患者的一种潜在治愈性治疗方法。文献中尚无关于该主题的报道。
